NCLEX Mod 3

The nurse provides discharge teaching for a client with a history of hypertension who had a femoropopliteal bypass graft. Which client statement indicates teaching is effective?

"I should observe the color and pulses of my legs every day."

The client is in atrial fibrillation. Which information should the nurse consider about atrial fibrillation when planning care for this client?

A loss of atrial kick

A client being treated for uncontrolled hypertension and chest pain calls out to the nurse and reports a nosebleed. Upon entry to the client's room, the nurse immediately applies pressure. Which action should the nurse take next?

Assess the client's blood pressure

Metoprolol is prescribed for a client with hypertension. For which side effect should the nurse monitor the client?

Bradycardia

The nurse is conducting a nutrition class for a group of clients with heart failure (HF). Which information is most important for the nurse to share with the class?

Choosing fresh or frozen vegetables instead of canned ones

A client with left ventricular heart failure is taking digoxin 0.25 mg daily. What changes does the nurse expect to find if this medication is therapeutically effective? .

Diuresis Decreased Edema Decreased pulse rate

Which clinical indicators is the nurse most likely to identify when taking the admission history of a client with right ventricular failure?

Edema Ascites

What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel?

Epistaxis

The nurse is planning to teach a client with heart failure about the signs and symptoms of cardiac decompensation. What clinical manifestations should the nurse include?

Extreme fatigue Coughing at night Difficulty breathing

When assessing a client, the nurse auscultates a murmur at the second left intercostal space (ICS) along the sternal border. This reflects sound from which valve?

Pulmonic

What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor?

The RR intervals are relatively consistent One P wave precedes each QRS complex

A client has surgery to replace a prolapsed mitral valve. What should the nurse teach the client?

The signs and symptoms of heart failure

The nurse is educating a client who is being discharged after insertion of a coronary artery stent. For what signs and symptoms should the nurse instruct the client to seek immediate medical attention?

Unexplained profuse diaphoresis Indigestion not relieved by antacids Acute chest pain after rigorous exercise Non remitting chest pain after three sublingual nitroglycerin tablets

A client's laboratory report indicates hyperkalemia. Which responses should the nurse expect the client to exhibit?

Vomiting Muscle Weakness Irregular Heart Rate

A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus?

Weight Smoking

A client with coronary artery disease is scheduled for a cardiac catheterization. What should the client be able to describe if the nurse's preoperative teaching is considered effective?

What will be experienced during the procedure

A client presents with bilateral leg pain and cramping in the lower extremities. The client has a history of cardiovascular disease, diabetes, and varicose veins. To guide the assessment of the pain and cramping, the nurse should include which question when completing the initial assessment?

"Does walking for long periods of time increase your pain?"

A client who has peripheral arterial disease of the lower extremities tells the nurse, "I walk so slowly that no one wants to walk with me." What is the best response by the nurse?

"A vascular rehabilitation program may help you."

A client who had several episodes of chest pain is scheduled for an exercise electrocardiogram (ECG). Which explanation should the nurse include when teaching the client about this procedure?

"This is a noninvasive test to check your heart's response to physical activity."

When a client exhibits severe bradycardia, which type of drug should the nurse be prepared to administer?

Anticholingergic

The nurse is caring for four clients. Which client should the nurse care for first?

Client D. Chest trauma

The nurse is caring for four clients on a medical unit. Which client should the nurse see first?

Client with chest pain

A nurse is caring for a community-dwelling older adult with hypertension. What interventions should the nurse take to ensure the client's well-being?

Promote dietary modifications by using varied techniques Assess the client's current lifestyle and promote lifestyle changes Monitor the client's blood pressure and weight and establish blood pressure screening programs

A client with a history of hypertension has a blood pressure of 180/102 mm Hg. When the nurse asks whether the client has been taking any medications, the client replies, "I took the blood pressure pills the healthcare provider prescribed for a few weeks, but I didn't feel any different, so I decided I'd only take them when I feel sick." What is the best initial response by the nurse?

"It is important to take your medications daily to achieve optimal results."

A client presents to the emergency department with weakness, dizziness, and difficulty breathing. The nurse performs an electrocardiogram (ECG) and notices this arrhythmia. Which arrhythmia is the client exhibiting?

Atrial Fibrillation